Peyronie’s disease is a condition whereby fibrous plaques (or scar tissue) develop along the shaft of the penis. The plaques can cause deformity in the penis, painful erections and difficulties with sexual intercourse. It may curve or adopt an hourglass shape when the penis is erect. The disease was named after François Gigot de la Peyronie, the French surgeon who first described it in 1743.
Treatment options include medicines taken by mouth, applied to the penis or injected into the scar tissue. Stretching, lasers and electrical treatment, and surgery are other options. In rare cases, the condition may clear up completely but most men find that it stays the same or gets worse over time.
Peyronie’s Disease Symptoms
People with Peyronie’s disease may suffer from:
- Painful erections – as well as areas of thickening along the shaft of the penis.
- Curved, angled or distorted shaft of the penis – most obvious when the penis is erect.
Peyronie’s Disease Diagnosis
In most cases the two symptoms above will be enough evidence for your doctor to diagnose Peyronie’s disease. Occasionally they may advise you to undergo a duplex ultrasound scan to show the blood circulation of the penis.
The doctor will typically want to measure the curvature or distortion of the penis whilst it is erect, which can either be assessed by photographs you have taken at home or (more accurately) by using a vacuum pump or an injection into the shaft to stimulate an erection.
Peyronie’s Disease Treatment
Non Surgical Options
There are many non-surgical treatment options available for Peyronie’s disease but they have not proven to work for all patients. These include:
- Medication – oral and/or topical medication.
- Injections – medicine injected into the plaques, may improve pain, the size of the plaques and the amount of bend in the penis.
- Stretching – or external penile traction, which involves wearing a device which stretches the penis, with the aim of improving the length of the penis and reducing the deformity.
- Vacuum devices – these stretch the shaft by creating a vacuum around the penis.
Peyronie’s Disease Surgery
Surgery is the only treatment guaranteed to have a beneficial effect on Peyronie’s disease. Surgery is only be offered to patients once the changes caused by the condition have settled down, which normally takes 12-18 months.
Surgery is not without risks and can include shortening of the penis and there is a chance the distortion may return. If your foreskin is already tight, you may require a circumcision as it may get even tighter after the operation. Some people report of feeling knots or stitches under the skin. You should carefully consider all these issues before consenting to surgery. Possible options include:
- Extracorporeal shock wave therapy – vibrations from sound waves are used to break down the tough fibrous plaques. Shock waves are delivered by a device outside the body.
- Nesbitt tuck procedure – removing some of the tissue from the side of the penis opposite the plaque. This straightens but shortens the penis.
- Cutting out plaque – sometimes combined with the insertion of a plastic rod (prosthesis) to counteract any shortening.
- Laser surgery – a carbon dioxide laser is used to thin the plaque.
- Plication – folding the normal tissue on itself rather than removing it completely.
If you have a mild version of the disease which does not cause much pain, if you are not sexually active, or have few or no difficulties with sexual intercourse, you may decide that you do not want treatment. About 13% of patients recover from their symptoms without treatment.
Peyronie’s Disease Specialists
At London Urology we specialise in Peyronie’s Disease with two expert and world-renowned Consultants able to treat the condition. Both Mr David Ralph and Mr Nim Christopher have many years of experience in treating Peyronie’s Disease and have both published various journals on the condition. To book an appointment with one of our specialists you can contact us by email at firstname.lastname@example.org or call our London Urology team on 020 7432 8297.